Organization
FAITH GROUP HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODERICK LAROW ROBERSON (OWNER)
(352) 396-1247
Entity
Organization
Contact information
Practice address
836 W DESOTO ST STE 5E, CLERMONT, FL 34711-2110
(352) 396-1247
(352) 394-2353
Mailing address
836 W DESOTO ST STE 5E, CLERMONT, FL 34711-2110
(352) 396-1247
(352) 394-2353
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103245100
—
FL
Enumeration date
10/28/2021
Last updated
10/28/2021
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